Background Carotid artery intima-media thickness (CIMT) is recently recommended as a noninvasive tool for primary prevention and the association with adverse cardiovascular events is also well known. We sought to evaluate the prevalence and the significance of carotid artery plaque especially in patients with coronary atherosclerosis. Methods Study population consisted of 1,705 consecutive patients (933males (54.7%), mean 59.7±10.9 years) underwent coronary angiogram and carotid artery scanning using high-resolution ultrasound. Carotid plaque was defined as uneven elevation with the CIMT >1.2mm. Results Carotid plaque was identified in 516 patients (30.3%) and located at common carotid artery (n=64/267, 24.0%), carotid bulb (n=194/267, 72.7%), and both site (n=9/267, 3.4%) in patients evaluated the plaque location (n=1027, 60.2%). The prevalence of hypertension (45.2% vs. 58.5%, p<0.001) and diabetes mellitus (22.8% vs. 29.1%, p=0.007) were higher in patients with carotid plaque. The patients with carotid plaque were older (57.2±10.7yrs vs. 65.4±8.9yrs, p<.0001), had thicker CIMT (0.77±0.16mm vs. 0.89±0.20mm, p<0.001), higher fasting blood sugar (FBS) (121.6±47.1mg/dL vs. 132.1±60.7mg/dL, p<0.001) and lower ejection fraction (65.11±9.4% vs. 63.1±11.9%, p<0.001) than those without carotid plaque. Acute coronary syndrome (23.9% vs. 32.4%, p<0.001) and significant coronary artery stenosis by coronary angiogram (59.2% vs. 75.4%, p<0.001), especially multi-vessel disease (27.3% vs. 46.4%, p<0.001), were more frequent in patients with carotid plaque. On univariate analysis, carotid plaque was associated with age (r=0.35, p<0.001), CIMT (r=0.30, p<0.001), FBS (r=0.09, p<0.001), hypertension (r=0.12, p<0.001), diabetes mellitus (r=0.07, p=0.006), HDL-cholesterol (r=-0.05, p=0.032). Conclusion Carotid plaque was common (30.3%) in Korean patients with coronary atherosclerosis, but it is still relatively uncommon compared to those of Westerns. It was related with old age, hypertension, diabetes, acute coronary syndrome, multi-vessel disease, and severe degree of coronary artery stenosis.
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